Kim Catherine, Harlow Siobán D, Kong Shengchun, Karvonen-Gutierrez Carrie, Ylitalo Kelly, Nan Bin
1 Department of Medicine, University of Michigan , Ann Arbor, Michigan.
J Womens Health (Larchmt). 2015 Jan;24(1):42-8. doi: 10.1089/jwh.2014.4839. Epub 2014 Dec 30.
Reproductive history, particularly maternal age at most recent birth, may reflect lower risk for chronic disease and mortality due to socioeconomic factors, lifestyle behaviors, or genetics. Reproductive history has not been examined with respect to hepatic steatosis, the most common liver disease in the United States. Our objective was to examine the association between reproductive history and hepatic steatosis.
We examined the association between reproductive history characteristics--specifically age at most recent birth--and the odds of moderate to severe hepatic steatosis using a population-based retrospective cohort study of women who underwent hepatic ultrasound at the Michigan site of the Study of Women's Health Across the Nation (n=331).
Women who gave birth at ≥ 35 years of age comprised 19% of the study population and were similar to other women regarding sociodemographic history and health behaviors. In multivariable analyses adjusting for age, race/ethnicity, chronic disease, and medications associated with hepatic steatosis, age at birth ≥ 35 years was associated with significantly decreased odds of hepatic steatosis (adjusted odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20-0.87), which was attenuated after adjustment for waist circumference (OR 0.51, 95% CI 0.24-1.10). Other reproductive factors including gravidity, parity, miscarriages and abortions, recall of gestational weight gain, breastfeeding, age at first birth, and age at final menstrual period were not associated with hepatic steatosis.
Women who were older at their most recent birth had a reduced odds of hepatic steatosis, possibly associated with their lower waist circumference.
生育史,尤其是最近一次生育时的母亲年龄,可能因社会经济因素、生活方式行为或基因而反映出患慢性病和死亡风险较低。尚未针对美国最常见的肝脏疾病——肝脂肪变性研究生育史。我们的目的是研究生育史与肝脂肪变性之间的关联。
我们采用基于人群的回顾性队列研究,对在全国女性健康研究密歇根站点接受肝脏超声检查的女性(n = 331)进行分析,研究生育史特征——特别是最近一次生育时的年龄——与中度至重度肝脂肪变性几率之间的关联。
年龄≥35岁生育的女性占研究人群的19%,在社会人口统计学史和健康行为方面与其他女性相似。在对年龄、种族/族裔、慢性病以及与肝脂肪变性相关的药物进行多变量分析时,出生年龄≥35岁与肝脂肪变性几率显著降低相关(调整后的优势比[OR]为0.41,95%置信区间[CI]为0.20 - 0.87),在调整腰围后这种关联减弱(OR为0.51,95%CI为0.24 - 1.10)。其他生育因素,包括妊娠次数、产次、流产和堕胎、回忆的孕期体重增加、母乳喂养、初产年龄以及末次月经年龄,均与肝脂肪变性无关。
最近一次生育时年龄较大的女性肝脂肪变性几率降低,可能与其较小的腰围有关。